Award Nomination Form

You will receive an email confirmation if the nominations have been approved.
Note ; No Self Nominations accepted on Club Nomination Form. Must be completed on the Student Nomination Form.

Full Name of Person Filling Out Form (Club Instructor/ Nominator) *

First NameLast Name

(Nominator) Phone Number*

(Nominator) Email Address*

example@example.com

Current Rank (Nominator) *

Current Club Location*

Teaching Title Meanings Information

Nominations Teaching Titles Karate (Purchase of Teaching Title Uniform by Club Instructor).

	Students Full Name Nominated (Multiple names with coma after each name
Kohai - Assistant Instructor in training
Senpai - Assisant Instructor
Dai Senpai - Assistant to Head Instructor
Sensei - Teacher
Renshi - Asistant Master
Shihan - Master Teacher
Kyoshi - Teacher of Teachers
Hanshi - Senior Master
Kancho - Head of School
Soke - Master of House
Meijin - Wiseman

Nominations Teaching Titles Kickboxing

	Students Full Name Nominated (Multiple names with coma after each name
Instructor (Senpai)
Kru - Assistant to Head Instructor (Dai Senpai in Karate)
Kru - Teacher (Sensei in Karate)
Kru Yai - (Renshi in Katrate)
Ajarn - (Kyoshi in Karate)
Pramajarn - (Grand Master)

Cross Meanings Information

Nominations Cross Awards (Purchase of Cross by Club Instructor )

	Bushido Cross Nominations (Full name with coma after each)	Ishoa Cross Nominations (Full name with coma after each)
Karate
Kickboxing

Nominations Recognition Awards

	Student Full Names Nominated (Multiple names with coma after each name )
Recognition Awards Min 5 years training
Recognition Awards Min 10 years training
Recognition Awards Min 15 years training
Recognition Awards Min 20 years training
Recognition Awards Min 25 years training
Recognition Awards Min 30 years training
Recognition Awards Min 35 years training
Hall of Fame Award (40+ Years Training)

Nominations Most Improved Student (One student per award/ per club)*

	Most improved Junior Student Full Name	Most Improved Senior Student Full Name
Karate
Kickboxing

Nominations Most Consistent Student (One student per award/per club) *

	Most Consistet Junior Student Full Name	Most Consistent Senior Student Full Name
Karate
Kickboxing

Additional comments to support Cross or Title Nominations (Only).

(Person completing form to sign ) - I sign this doc with the understanding that my nomination still needs to be approved. *

Award Nomination Form - Club Instructors